The Optimization of the Post-Rehabilitation Process Heart Surgery: Our New Proposal Physiotherapy Record

To the Editor, We read with interest the research by Torun 1 on the multiple benefits that resistance exercise (RE) can have in the treatment of coronary heart disease, peripheral artery disease, heart failure, and cardiac rehabilitation.However, we noticed that the article does not mention scales of judgment for patients undergoing these exercises, and it seems important to us to emphasize this aspect.Recently, Korean colleagues on the structuring of the organization of cardiac rehabilitation according to shared guidelines had made what seems to us to be an omission, which is also present in the Scottish guidelines (Scottish Intercollegiate Guidelines Network, SIGN). 2 Furthermore, we must recognize that there are limitations in the management by the multidisciplinary team of physiatrists, cardiologists, cardiac surgeons, geriatricians and physiotherapists in the care of chronic patients in the area of cardiovascular rehabilitation.In particular, there are several gaps in the management of frail patients, due to the presence of substantial heterogeneity in the care of these patients due to the presence of physiotherapy records designed in a very different way and present in the various centers.All this is also evident from the analysis of the guidelines mentioned.We carried out a search between December 2023 and March 2024 using PubMed as a database to collect the scientific literature available regarding cardiac rehabilitation, its benefits, complications, and the most effective evaluation scales that can be used for the purposes of a correct physiotherapy evaluation.The string used was the following: ((((Cardiac Rehabilitation [MeSH Terms]) AND (Exercise[MeSH Terms])) AND (exercise therapy[MeSH Terms])) AND (Prevention [All Fields])).The following filters were inserted: "Humans," "Clinical Trial," "Meta Analysis," "Randomized Controlled Trial."Furthermore, only articles published between 2016 and 2024 were considered.The search resulted in 16 articles, and then we viewed the abstracts: 8 articles were excluded as they were not relevant to the research carried out, leaving 8 articles.Then, we carried out another search on PubMed with the following string: ((((Activities of Daily Living [MeSH Terms]) AND (Walking [MeSH Terms])) AND (Time [MeSH Terms])) AND (mobility [All Fields])) AND (evaluation scale [All Fields]).The following filters were inserted: "Humans" and "English."The search resulted in 17 articles, and after viewing the abstracts, 15 articles were excluded as they were not relevant to the research carried out (with 2 remaining articles).Finally, another search was carried out on PubMed with the following string: (((Accidental Falls [MeSH Terms]) AND (Risk Assessment [MeSH Terms])) AND (incidence [MeSH Terms])) AND (Adult [MeSH Terms]).We inserted the same filters of previous research, yielding 32 results, of which 28 were excluded.Therefore, 14 studies were included in our review (Figure 1).The rating scales are designed to evaluate specific parameters such as the degree of disability, functional independence, clinical symptoms, physical and/or cognitive functions, emotional state, well-being, and socio-work functions.They can be used to monitor changes in the patient during the rehabilitation treatment and to evaluate the effectiveness of therapeutic interventions.We have selected the following scales as useful scores and assessments for the